Manifestações bucais e manejo odontológico de pacientes com doença renal crônica: revisão de literatura

Abstract

Chronic Kidney Disease (CKD) is developed by the change in the functioning of the renal cortex, where the filtration of substances that must be eliminated from the body for hemostatic and nutrient control occurs, causing several systemic changes with manifestations in oral health. medical and dental monitoring of these patients is necessary, as CKD is generally associated with diabetes, hypertension, bone, coagulation and immunological alterations; in addition, the use of medications in the systemic treatment of chronic renal patients may make them susceptible to the emergence of pathologies such as stomatitis. The objective of this study was to know the main manifestations of CKD in the mouth of these patients, to point out pharmaceuticals of dental applicability for use in chronic kidney patients and to highlight the importance of the dentist (DC) in their management. A narrative literature review was carried out, with data searches in the PubMed, MedLine, Scielo and VHL platforms with the descriptors in Portuguese “Oral diseases”, “Chronic kidney disease”, “Dental care” and in English “Mouth diseases”, “ Chronic renal diseases”, “Dental care”; the inclusion criteria were articles published in scientific journals, clinical research, literature and systematic reviews, theses, dissertations and reports, between 2010 and 2020; excluding incomplete works, monographs and publications in years prior to 2010. Considering the broad pathological aspects of CKD in the body, it was concluded that the most evident oral manifestations are periodontal disease, xerostomia and uremic stomatitis. Regarding the choice and applicability of pharmacological therapy for these patients, dental management should be based on the systemic condition, through evaluation by a multidisciplinary team involved in the treatment of chronic renal patients; in addition, medications used in dentistry must undergo changes in dosages and administration rates according to the degree of involvement of the CKD; showing that the dentist is essential in the follow-up and/or dental treatment of patients with CKD, because through dental interventions, the CD can improve the systemic condition of CKD and promote an improvement in quality of life.